Tagged: #ethics
- This topic has 18 replies, 13 voices, and was last updated 1 year, 5 months ago by Tanatorn Tilkanont.
-
AuthorPosts
-
-
2022-09-29 at 3:41 pm #38431SaranathKeymaster
Please watch the VDO for topic discussion.
-
2022-10-07 at 4:49 pm #38571ABDILLAH FARKHANParticipant
The essential ethical principle we should keep is that disclosing someone’s HIV status without his/her personal consent is extremely prohibited. Informing to patient’s wife who at the same moment is our friend will clash with our professional duty as an informatician and this is considered a conflict of interest. If I were a health informatician and know his positivity status by just checking his medical records, revealing his HIV status to his loved ones is not my responsibility. Conversely, my competency and obligation are to hold and ensure his medical information is secure under the medical record system.
I don’t deny that it is important to recognize the rights of the patient’s family to know about the patient’s HIV status, but there is an HIV counselor (could be a doctor or other valuable health professional) who preserves the rights of the patient during his medical condition and works with the patient to support his well-being. The counselor plays an important role to encourage the willingness of the patient to open his HIV status under the counselor’s guidance. Even if the counselor possesses the power to make decisions that pre-empt patient’s choice, counselor is ought to realize that the patient is also capable of making his decision.
Another choice such as approaching the counselor and influencing him/her to make the patient is ready may not always be the fine option, and it does not reflect ‘self-determination and right for doing good and doing no harm to other’. It may interfere patient’s privacy which makes his life threatened due to my knowledge.
-
2022-10-08 at 2:04 pm #38583PREUT ASSAWAWORRARITParticipant
In my opinion, there are two main issues in this scenario. First of all, the health information system should not allow the users, for example, health information professionals other than physicians be able to access to HIV status of the patients. This can be prevented by asking for physician authentication to open the anti-HIV result. The users have to enter username and password again to see the laboratory results. Second, if that health information professional is a physician in that hospital. He should have ethics regarding privacy of patients. The HIV status is confidential between physicians and patients. He has to ignore the laboratory result and would not tell anyone. He should keep in mind that the person who has the right to disclose this secret is the patient himself. In general, we encourage every HIV-infected patient to disclose the HIV status with their partner because their partner should have the test and take anti-viral medication to prevent further opportunistic infection.
Follows are the answer specific to each question.
1. What should you do?
– Just ignore the result. I cannot tell the result to anyone.
2. As a health information professional, can you tell your friend?
– Definitely not.
3. Can you interfere with other people or family issue?
– Probably yes, if I am familiar with the physician who take care the patient to encourage him to disclose the result with his wife.
4. But should your friend not know about this because she might be at risk?
– Of course, she should know this issue. However, the keyperson who response to disclose this result is the patient himself.
5. How will you follow the fundamental principles about right to self-determination, doing good and doing no harm to others?
– Patient has the ultimate decision-making responsibility for their own treatment or disclosure of their status.
6. Isn’t it your obligation and the right of subject to hold the information?
– It is the right of subject to hold the information.-
2022-10-11 at 7:06 pm #38632Siriphak PongthaiParticipant
Thank you for sharing. I agree with you! The crucial laboratory result like anti-HIV should be restricted only for physicians. Those who are not involved should not get access into this kind of information.
-
-
2022-10-08 at 2:46 pm #38584Kawin WongthamarinParticipant
I think that the EMR check process should mask the name of the examinee to prevent bias and I agree with Mr.Preut that accession to highly sensitive information should be limited to a patient and physicians who the patient has given permission to access the information.
To answer the above question I think good workers should be able to distinguish between work and personal matters appropriately. Job secrets must not be shared with outsiders, even if they are family or close friends. if I were a health information professional, I wouldn’t have the right to talk directly to patients about this information. I think that If this information is leaked, it would hurt the owner of the data, so I will keep this a secret. Finally, everyone has the right to make their own decisions based on the principles of Autonomy. Therefore, patients have the right to decide whether or not to disclose their information.
-
2022-10-10 at 8:30 am #38607Boonyarat KanjanapongpornParticipant
If I am a Health information professional in this situation, I wouldn’t tell my friend about her husband’s health status from EMR. I would consider details about his health and treatment as confidential information which should be protected.
With autonomy in health care patients should be able to self-determine, meaning he is capable to decide on holding his own health data, and others should respect the decision. However, his decision causes others danger because his wife would be able to come infected. I am not sure if there are limits on autonomy that causes harm to the public, but this consideration might come under his physician more than an informatician.
With the health informatician position possibly under the third-party company, I wouldn’t reveal his data. I would decide to respect his determination after he consulted with his physician, protect confidential data and protect the rights of the patient.
-
2022-10-11 at 10:01 am #38614Zarni Lynn KyawParticipant
In the view of health informatics ethic, the answer is clear in my opinion, we should not tell the friend about the husband’s HIV status but in the real-world situation, the answer is much more nuanced. If the HIV diagnosis is recent, the husband may like a second opinion or even another confirmation before telling the wife. It is his right to do so as medical errors happen all the time. To answer according to the prompt questions,
1. What should you do?
– Health professional must stick to the ethical principles and individual’s right to privacy and confidentiality
2. As a health information professional, can you tell your friend?
– We should not and must not tell any other party.
3. Can you interfere with other people or family issue?
– Coming from a background of a medical doctor, we can use counseling techniques (before HIV test, pre-counseling is mandatory in my country) to make sure the HIV positive patients take all the precaution necessary to prevent the spread of the disease.
4. But should your friend not know about this because she might be at risk?
– As a public health professional, we must do everything we can to spread an infectious disease but within the ethical boundaries. In an ideal world when a married person took an HIV test pre-counseling of both patient and spouse is done.
5. How will you follow the fundamental principles about right to self-determination, doing good and doing no harm to others?
– Following the fundamental principles about right to self-determination, we must not disclose the HIV status of the patient without his informed consent and following the doing good and doing no harm to others principle we will conduct proper pre-counseling and post-counseling services.
6. Isn’t it your obligation and the right of subject to hold the information?
– It is my obligation to follow the ethical principles to not disclose information without patient’s consent and it is the right of subject to hold the information but as a health professional we must do everything we can to limit the spread of disease within the bounds of ethical standards.-
2022-10-11 at 1:51 pm #38621Boonyarat KanjanapongpornParticipant
I totally agree with you.This is sophisticate situation for me to select between respecting the right to self-determinate and limit the spread of disease.
-
-
2022-10-11 at 8:32 pm #38633Siriphak PongthaiParticipant
1. What should you do?
Answer: If I were a character mentioned in the scenario, I won’t access to patient’s information which I am not involve with. Due to the ethical consideration, personal information should be maintained private, confidential, and respectful.2. As a health information professional, can you tell your friend?
Answer: Definitely as a health information professional, with any reasons, we cannot disclose his health information to our friends.3. Can you interfere with other people or family issue?
Answer: No, I don’t think so. As we are health information professional, we should not interfere with other people or family issue unless he consents or asks for advice and help.4. But, should your friend not know about this because she might be at risk?
Answer: Yes, I know she is at risk of getting infection. However, because of ethical consideration, the patient’s health information should be disclosed by patient himself.5. How will you follow the fundamental principles about right to self-determination, doing good and doing no harm to others?
Answer: We must not disclose health information of patient without agreement or consent.6. Isn’t it your obligation and the right of subject to hold the information?
Answer: It is the right of subject to hold the information. It depends on whether or not they will disclose their own information.-
2022-10-12 at 8:58 pm #38676Kansiri ApinantanakulParticipant
Thank you for sharing.
I agree with you for the subject privacy concern.
-
-
2022-10-12 at 1:36 am #38640Tanyawat SaisongcrohParticipant
As a health information professional, who assigned duty and has authorized to check on patients EMR, we have to strictly follow the principle of ethical informatics of respect the subject, privacy and do no harm.
1.What should you do? Ignore the result and focus only on the relevant assigned duty on EMR
2.As a health information professional, can you tell your friend? Definitely not. This is a confidential data of the patient and he has the right to self-determination.
3.Can you interfere with other people or family issue? If the issue could be harmful to others, the answer might be yes but with condition, who and how. Who means the counselor or physician in charge and how is about counseling process. However, the patient himself has the right for the final decision with the result.
4.But should your friend not know about this because she might be at risk? Of course, she should know because she might be at risk but not from the third party. It’s only patient himself to disclose this data.
5.How will you follow the fundamental principles about right to self-determination, doing good and doing no harm to others? We have to keep in mind and practice our professionalism with the highest standard of ethical issues
6.Isn’t it your obligation and the right of subject to hold the information? It is the right of patient or subject to hold their personal information and we, as a health informatics professional should not disclose PHI or health data in violation of legal requirements and accepted local confidentially practices. -
2022-10-12 at 5:32 am #38644Hazem AbouelfetouhParticipant
As a health information professional, It is my duty to not disclose sensitive information including lab results to anyone without the patient’s explicit informed consent. I believe it is inappropriate to interfere with other people and family issues.
Professional regulatory bodies, legislatures, and courts have recognized that in some circumstances, patient confidentiality may give way to protect others who are thought to be at risk of harm. We should refer to standards and laws in the region for guidance.
In addition, under public health legislation in every province and territory, HIV (and/or AIDS) is a reportable illness. You might be required to report HIV diagnoses to public health authorities. The reportable details could include the patient’s name, risk factors, and demographic information. Reporting obligations vary, so we should check the applicable laws and regulations in the region.
-
2022-10-12 at 8:59 pm #38677Kansiri ApinantanakulParticipant
I agree with you that not only ethics we concerned, but the local law and regulation must be thoroughly reviewed.
-
-
2022-10-12 at 8:55 pm #38675Kansiri ApinantanakulParticipant
1. What should you do?
Corrective action: I would instantly close the window of my friend husband HIV record since this is the sensitive information and this may violate the privacy of the patients. By inappropriate storage of the sensitive data, this may violate the local regulation for example PDPA.Preventive action: Raised the concern to manager to redacted/limit the access for this kind of information for all patient
2. As a health information professional, can you tell your friend?
My answer to this question is “No” since it’s my responsibility to keep patient privacy3. Can you interfere with other people or family issue?
As a friend I might say “yes” but I would keep the minimal interference.
As a health informatician, it would definitely “no”.4. But, should your friend not know about this because she might be at risk?
This question is dilemma which may occurred in real life situation.
I agreed that my friend would at risk of HIV infection, but the HIV result is not the information that should be disclosed by other people. We should let him tell his wife by himself.5. How will you follow the fundamental principles about right to self-determination, doing good and doing no harm to others?
The question is super hard to answer. If I told this information to my friend, she might break up with her husband. She may avoid the HIV risk, but this could ruin her love life.
I’m not quite sure this is doing good or not, but this violates the privacy of the patient.Only possible method that come in my mind is that I may give the annual health check (including the HIV test) voucher to both. Just let the health check result speak for me.
In case they both don’t come, It’s out of my scope to help them both.6. Isn’t it your obligation and the right of subject to hold the information?
Yes, It’s the right of the subject to hold this information-
2022-10-12 at 11:23 pm #38685SIPPAPAS WANGSRIParticipant
Interesting! I like how you address a preventive action. This kind of situation, especially sensitive information such as serological status of the patient must be kept securely and only authorised personnel can access. I guess as a system administrator, we are technically the most privileged users and that’s why we all have to abide by professional ethics!
-
-
2022-10-12 at 11:19 pm #38684SIPPAPAS WANGSRIParticipant
This is the most basic patient’s rights! The only answer is NO. Patient confidentiality is what we must respect and it is not our job in the first place. So I would just ignore and continue my work — checking the EMR. I can’t interfere with other people’s issues, even in a “friendly” situation because where I gained this information is because I accidentally found it. I was not even a physician who ordered the test, so I have no right to bring this issue up and talk about it in any way. So, speaking of should my friend not know about this because she might be at risk.. well, to be honest I really think she should have been informed, but like I said, I am in no position to do that as I believe that the physician who ordered this test must have given the husband a choice and prior counselling beforehand. If I were a physician who conducted the HIV test for the husband, I would try my best to convince him to tell his partner (in other word, my friend). That’s the best I can do and I am obliged to withhold that information from any one other than him.
-
2022-10-24 at 6:34 pm #38831Tanatorn TilkanontParticipant
I agree with your answer. I also believe that physician would already inform the patient and it is patient’s choice to choose whether to tell his wife or not. It is the right of the patient to decide his data disclosure. Thank you for sharing.
-
-
2022-10-16 at 7:37 am #38714SaranathKeymaster
Thanks for sharing and provide preventive measures. It seems that everyone had an opinion in the same direction.
-
2022-10-24 at 6:28 pm #38830Tanatorn TilkanontParticipant
What should you do?
Ans. I will close it immediately at the time I saw the information. This is a sensitive data. The system developer should blind this sensitive information and only allow specific users such as physicians, unless, there is a purpose to collect data for further processes. Also, I will have to report this to system developers to setup authority and role for accessing the personal sensitive data.As a health information professional – can you tell your friend?
Ans. No, due to the subject’s confidentiality. I should not disclose subject’s privacy data to other peoples, even my friend’s husband.Can you interfere with other people or family issue? But, should your friend not know about this because she might be at risk?
Ans. I should not interfere with other people, even their family. All people have the right to self-determination and right to disclose their information. If I have a chance I may look for an alternative way to let my friend be aware of without a direct approach, such as suggesting her and her husband to have an annual health check-up every year.How will you follow the fundamental principles about right to self-determination, doing good and doing no harm to others?
Ans. Following the fundamental principles about the right to self-determination, I should not disclose the subject’s private information and give the right to subject to make decisions.Isn’t it your obligation and the right of the subject to hold the information?
Ans. It is the right of subject to hold the information. I should not disclose the subject’s data.
-
-
AuthorPosts
You must be logged in to reply to this topic. Login here